Laserfiche WebLink
everen APPLICATION FOR RIGHT-OF-WAY USE PERMIT <br /> - .. 10934 <br /> � . <br /> CITY ENGINEERS �� � ' <br /> EVERETT,WASHINGTON � <br /> PERMiTNf1. ��' '>'d <br /> The Undersigned i . � <br /> Hereby appli=s for permission to <br /> — _...1� ' /`%, <br /> � <br /> At ihe following bcation -� - � <br /> SKETCH ��.�_I � '..'.i.,�. r.� �/ : - � .�1 � .C� <br /> (Work to be aane) . <br /> I <br /> �� <br /> 1 DRIVEWAY SECTION The undersigned owner hereby agrees to hold and <br /> � NO SCALE-- scve harmless the City of Everett trom anv and ail <br /> . � � claims for damages that may arise because of installa� <br /> +�" ��P i J tion and maintenance of ihe improvement herero <br /> �.30" I __ _ __. I 30�� applieA for and lurther agrees to remove same upon <br /> ��� —�f� notice from the City and to replace public property <br /> Aamaged thereb��. <br /> �; , <br /> � Signature o!App i�cant—'�'a-l'=� <br /> ;i „^.� "-7'l/ 7 <br /> r,oi�vorliii;nri�ucni�iuivio nddress —�— <br /> � IiE POSTf_D OIV JOBSIT-L ' S r" / �`r) <br /> CAI_L ENGINEEqIWG DEPT. 759�881 t � Telephone Number <br /> I ?q li(`URS REf"ORE CCN'��.TRI'CliO!1� � .. i_. 'l � <br /> , - . . . . Dare � i — <br /> CHECK LIST /Y <br /> Water Valve Fee <br /> Drainage Dept. Approvals <br /> Curb$Gutter Engineers_ <br /> Sidewalk <br /> Water <br /> Sireet <br /> Inspector s Signaturc Ccmmunications <br /> Traffic <br /> Planning <br /> ai�— — -- <br /> Remarks <br /> Note: Original to Customer — <br /> i Copv to File L !1'�� � <br /> 1 Copy to Inspccror � � <br /> Approved by <br /> D;qe APP��ved <br />